What is the Difference Between Appealing Denials of Private Disability Benefits and ERISA-Governed Benefits?

What is the Difference Between Appealing Denials of Private Disability Benefits and ERISA-Governed Benefits?

Individuals may purchase private disability benefits policies, or their employers may offer disability insurance plans as a benefit of their employment. In most cases, employer-sponsored disability coverage is subject to the Employee Retirement Security Income Act (ERISA), whereas private disability insurance policies are not. The rules, deadlines, and procedures that apply to ERISA-governed disability plans are very different than those that apply to individual disability insurance plans, including those concerning appealing a denial of benefits.

For instance, if you are denied long-term disability benefits under an ERISA-governed plan, you have a strict 180-day deadline in which to appeal your denial of benefits. If you are denied disability benefits under a private insurance plan, however, there is not such a harsh deadline for an appeal.

Another significant difference between the two types of disability insurance plans is concerning the provision of medical and vocational evidence to prove your disability. In a plan that is subject to ERISA, you must provide all the information necessary to prove that you are disabled during the claims process. If you leave out any of this information during the administrative process, you risk being unable to use that information if you must appeal the denial of benefits in federal court. You also will be unable to submit any new evidence to the court, no matter how helpful it may be to your case.

On the other hand, if you are appealing the denial of private insurance benefits, you can prove your disability throughout your lawsuit. You can submit additional evidence in support of your disability, even if you obtained the evidence after you filed your initial claim for benefits. The ability to offer new and further evidence can make it easier to establish your disability, which can lead to a higher likelihood of success in your appeal.

We know that you are facing disability-related legal issues that can be crucial to your future. As a result, the attorneys at Bonnici Law Group have the skills and knowledge to advise you of all potential options. We know how vital this support can be to you when you are unable to work. As a result, we are here to represent your interests throughout any dealings that you must have with your insurance company. For legal advice about your claim, please contact Bonnici Law Group at 619-259-5199 or help@bonnicilawgroup.com.

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